Cardio MRI Research Study
521-14-4-4195-0200
Statement of Work for Cardiovascular MRI
Brain atrophy is the radiological measurement which correlates most strongly with disability in progressive MS. Longitudinal research has revealed similar rates of atrophy regardless of clinical subtype, suggesting that this final common indicator of axonal loss is evident in all stages and subtypes of MS. In other words, brain atrophy indicates axonal and neuronal loss due to inflammatory activity as well as neurodegenerative processes. Thus, measuring atrophy takes into account both the inflammatory and neurodegenerative processes at work in progressive MS.
Although several methods of measuring brain volume are available, in MS the BPF is most widely used and correlates well with disability outcomes".
Methods. MRI will be performed on a Philips Achieva 3T head-only scanner. All scans will be performed on the same machine according to the 2003 Consortium of Multiple Sclerosis Centers imaging guidelines (below):
1. Anatomic scouts. These scouts will be used for scan planning (Total scan time = 20 s)
2. Dark Fluid/FLAIR-1 (fluid attenuating inversion recovery).Sagittal plane, Field of View = 230 mm2, Matrix = 256 x 256, TRITE/TI = 10,000199/2150 ms, 3 mm slice thickness, no inter-slice gap, 40 slices, Voxel size = 0.9 x 0.9 x 3.0 mm, Scan time = 7:02
3. Dark Fluid/FLAIR-2 (fluid attenuating inversion recovery)Axial plane, Field of View = 230 mm2, Matrix = 256 x 256, TRITE/TI = 10,000199/2150 ms, 3 mm slice thickness, no inter-slice gap, 40 slices, Voxel size = 0.9 x 0.9 x 3.0 mm, Scan time = 7:02
4. Proton Density/T2 weightedAxial plane, Field of view = 230 mm2, Matrix = 256 x 256, TR/TE1/TE2 = 6,000/18/105 ms, 3 mm slice thickness, no inter-slice gap, 40 slices, Voxel size = 0.9 x 0.9 x 3.0 mm, Scan time = 4:50
5. Post-Gd T1 weighted*. Spin Echo T1 series, Field of View = 230 mm2, Matrix = 256 x 256, TR/TE = 760/12 ms, 3 mm slice thickness, no inter-slice gap , 40 slices, Scan time = 3:18*A Gadolinium-based contrast agent (Magnevist) will be injected (IV) at 0.1 mmol/kg of patient weight, 5 minutes prior to post-Gd T1 image acquisition. The injection will be at a rate of 2 ml/s and will be performed using a power injector.
The estimated total time for each MRI will be approximately 30 minutes per study.
All MRI images will be read for incidental findings by a credentialed neurologist or radiologist, and image files will be stored in anonymized DICOM format in the Pl's office. To calculate BPF, we will perform an automated analysis using SIENA (Structural Image Evaluation, using Normalisation of Atrophy, University of Oxford)7980. In SIENA, brain tissue is segmented from non-brain tissue, and brain surface area and brain volume are measured. BPF is then calculated as a ratio of brain parenchymal tissue to total volume within the brain surface contour. Change in volume between two time points determines the rate of atrophy.
The possibility for bias in analyzing the scans will be minimized since SIENA is automated, and since MRIs will be batched and analyzed in groups of 5.
Interpretation of Results. Rates of atrophy will be calculated as percent change in BPF per subject per study period (on-lithium vs. off-lithium). Results will then be compared using a T-test for paired data in which percent change during the lithium-treatment period will be compared to percent change during the off-lithium period. A significant difference in the percent change in BPF favoring the lithium-treatment period will be interpreted as evidence of lithium's effect on decreasing the rate of atrophy on axonal integrity.
Interested offers shall e-mail contract specialist, Connie Ganier at connie.ganier@va.gov no later than Noon EST on 6 August 2014.
Connie Ganier
Contract Specialist
205-933-8101 x6018
Contract Specialist e-mail address
